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. 2013 Jul;5(3):115-7.
doi: 10.4103/0974-7753.125599.

Proliferating trichilemmal cyst: the value of ki67 immunostaining

Lucia Rangel-Gamboa  1 , Magdalena Reyes-Castro  2 , Judith Dominguez-Cherit  3 , Elisa Vega-Memije  1
Affiliations

Proliferating trichilemmal cyst: the value of ki67 immunostaining

Lucia Rangel-Gamboa et al. Int J Trichology. 2013 Jul.

Abstract

Background: A proliferating trichilemmal cyst (PTC) is an uncommon, rapidly-reproducing cutaneous epithelial cyst, differentiating from the isthmic portion of the outer hair root sheath. It is usually described as a benign tumor, but malignant transformation has been reported and is then denominated as a malignant proliferating trichilemmal tumor. Ki67 immunostaining has been used as a methodology for the evaluation of tumor grade in other tumors, due to its distinctive reaction patterns which exclusively involve proliferating cells.

Objectives: (1) To report the incidence of cases of PTCs in a General Hospital during a 12 years period. (2) To determine the expression of ki67 using immunohistochemical staining. (3) To correlate ki67 reaction patterns with clinical prognosis.

Materials and methods: The dermatology department's files during a period of 12 years were reviewed; cases with a diagnosis of PTC were selected, and ki67 immunostaining was done when enough biological material was available.

Results: A total of 15 cases with a diagnosis of PTC were identified. In 12 cases, ki67 immunostaining was carried out. In 9 of the 12 cases, ki67 was observed in the basal cells of the cystic epithelium, one case was moderately positive in palisading epithelial cells; in the other two cases ki67 immunostaining was negative. Clinical follow-up was done and revealed that no patient had local recurrence in 5 years after surgical removal of PTC. We therefore consider this immunostaining technique is probably correlated with low recurrence potential.

Keywords: Hair follicle; ki67; pilar tumor; proliferating trichilemmal cyst.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
A multilobulated tumor is observed in the scalp
Figure 2
Figure 2
Panoramic view of the lesion, showing lobules formed by aggregations of squamous epithelial cells, peripherally palisading epithelial cells maturing into large pale-staining cells displaying an abrupt trichilemmal type of keratinization
Figure 3
Figure 3
Immunohistochemical staining with ki67 observed in the palisading epithelial basal cells of the cystic epithelium
See this image and copyright information in PMC

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